October 14, 2010

The great majority of older adults say they'd prefer to live out their days in their own home. For many, this desire is so strong that they’ll insist on staying in the face of what seems to be an impossible situation.

But even as a friend or relative begins to decline and need more support, "aging in place" can usually continue to work.

The good news is that there’s a wide and growing array of supports available to help older adults age in place safely and in comfort, from high-tech home-monitoring systems to skilled in-home caregivers. The key to successful aging in place is learning about these supports -- and how to "future-proof" her home -- before a health crisis or other emergency strikes.

Practical needs to consider include:

Transportation. Driving -- which many older adults perceive as the key to their independence -- is a touchy subject, but talking about it is crucial, as is assessing an older adult's ability to continue to drive safely. If she does lose the ability to drive, there are a number of available alternatives, from paratransit and door-to-door vans to enlisting family, friends, and church members to help out with rides on a rotating basis.

In-home safety. You'll want to do a top-to-bottom review of her home for comfort and potential safety hazards. Put yourself in her shoes and look for (and be prepared to install) things like bright lighting throughout the house, light switches at the top and bottom of stairs, and grab bars in the bathroom, for starters. A certified aging-in-place specialist can make suggestions and help figure out how to implement needed changes.

Finances. Like driving, money is a touchy subject, but it's important for aging-in-place older adults to have a clear sense of their financial resources and how long they will last, especially if their need for in-home care increases.

Assuming that your friend or relative is comfortable discussing finances with you, sit down with her and go over whether she has the income to cover her needs over time, including in-home care should it become necessary. A financial planner who specializes in eldercare can help. If it looks like there's going to be a lack of funds, become familiar with financial options, from reverse mortgages to Medicaid's Cash and Counseling program, which pays for in-home care in some states, for those eligible.

Healthcare. Again, planning is key. If she's willing, review her healthcare coverage with her and make a list of her doctors and nearby hospitals. Make sure everyone caring for her knows what the plan is if a medical problem arises on the weekend or on a holiday. The more information you have at hand before something happens, the better prepared you'll be to help when it does.

Household maintenance. One of the main reasons older adults wind up moving to retirement communities is because they have trouble "keeping up with the house." But if you make a list of household tasks -- both routine and intermittent (mowing the lawn, cleaning the rain gutters, taking the trash cans to the curb) -- and figure out together which tasks she can still handle and which she needs help with, an unwanted move can often be avoided.

The next step is figuring out who's available -- volunteers or professionals -- to help. A neighbor may be more than happy to take out the trash cans each week, and more time-consuming maintenance tasks can be delegated to a handyman or gardener. If you live nearby and are willing help with something as minor as changing a light bulb that requires climbing a ladder, let her know -- it will bring her and you peace of mind, and will help keep her safe.